FIELD DOG STUD BOOK APPLICATION FOR REGISTRATION — FEE: $20.00
AMERICAN FIELD PUBLISHING CO., 542 S. Dearborn Street, Chicago, IL 60605 • Phone: (312) 663-9797
SERVING SPORTING DOGS FOR OVER 130 YEARS
Certificate of Registration Issued Within 30 days After Receipt of Application
Application forms become a part of the files and records of the F.D.S.B. and will not be returned.
Publishers Field Dog Stud Book: I offer for registration the dog described below. Fee: TWENTY DOLLARS.
[THE COST OF THE PEDIGREE IS IN ADDITION TO THE REGISTRATION FEE.]
Obtain a Certified Pedigree of the dog covered by this application at the following rates:
3 generations—$15.00; with wins—$20.00
4 generations—$22.00; with wins—$30.00
5 generations—$32.00; with wins—$40.00
* * NOTE * *
Please fill in diagram
Owner
(Print or Typewrite to Avoid Errors)
Street
City
State
Day Phone
Zip Code
E-mail
FDSB Litter
Name claimed (Select three choices)
Maximum four words or initials for each name, which is not to exceed a total of 24 letters.
Enrollment No.
(First choice)
(Second choice)
(Third choice)
Indicate
principal
markings for
identification
Breed
Sex
Color
Date Whelped
(Give predominating color first)
Registration No.
{ Sire’s Sire
{
{ Sire’s Dam
Registration No.
{ Dam’s Sire
{
{ Dam’s Dam
Sire
Dam
(Dogs submitted for registration must be from an enrolled litter.)
Owner (or Lessee) of Sire
Address
(At time of service)
Owner (or Lessee) of Dam
Address
(At time of service)
If dog offered for registration in another recognized stud book, give number
and attach photocopy of the certificate
of registration, with additional $10.00 fee. If registered in a foreign stud book, an official three generation pedigree is also required.
CERTIFICATE FOR OWNER OF DAM MUST BE COMPLETED AND SIGNED
I HEREBY CERTIFY
That my Female (Name)
No.
Stud Book Number
Was bred to
No.
Name of stud dog
Breed
Color
Of Dam
Of Dam
Date of birth of Dam
Number and sex in litter
Date puppies were whelped
Males
Date
on
Stud Book Number
Females
Personal Signature*
Owner or leassee of dam at time of service
Town
State
*Required! Photocopy not acceptable. Please do not use black ink!